Job Description:
• Ensure accurate and timely filing of dental claims for assigned offices
• Review Accounts Receivable reports and follow up on outstanding insurance claims and balances
• Review clinical notes, x-rays, and account ledgers for cohesive information
• Create and submit electronic and paper claims with required attachments, including orthodontic claims
• Send claims through the clearinghouse and manage invalid and rejected claims
• Send claims within 48 hours of the date of service
• Report account and claim issues to dental offices or designated team members and track required corrections
• File corrected claims triaged from the AR Specialist
• Contact insurance companies regarding claim issues and non-payments
• Complete appeals and insurance company requests
• Review returned EOBs, including denials, missing information, attachments, corrected claims, and retractions
• Track outstanding insurance balances by category and report completion to the OM
• Participate in special projects and assigned tasks
• Cover for other Claims/AR Coordinators as needed
• Assist with and conduct training for new CBO team members
• Attend and contribute to monthly meetings
• Report grievances or issues to CBO-RCM
Requirements:
• Previous experience in dental office administration, dental billing, or insurance claims processing is highly beneficial
• Experience in medical claims processing may also be considered
• Familiarity with dental terminology and procedures
• Understanding of dental insurance policies, coverage limitations, and claim submission procedures
• Knowledge of common insurance codes, including CDT codes, and ADA dental claim forms
• Detail-oriented claim review and discrepancy identification
• Strong verbal and written communication skills
• Ability to manage and prioritize multiple tasks
• Proficiency with dental practice management software and other computer applications used for claim processing and administrative tasks
• Good customer service skills for handling billing and insurance inquiries
• Ability to troubleshoot claim-processing issues, billing errors, and insurance coverage discrepancies
• Knowledge of and adherence to HIPAA and legal and ethical billing guidelines
Benefits: